Hi, welcome to our video series on interpreting lab values. In this portion of the series, we're
going to look at asymptomatic bacteriuria. Now you may be asking yourself what is
asymptomatic bacteriuria? Well, even if you weren't, I'm going to tell you because I love to
give you an opportunity to learn more about medical terminology. See, a- means without,
symptomatic means symptoms. So, asymptomatic means without symptoms. Bacteri- stands
for bacteria and -uria refers to urine. So, asymptomatic bacteriuria means you have bacteria
in your urine but you're not exhibiting symptoms. So we broke down the medical terminology
but asymptomatic bacteriuria or AB is the isolation of a bacteria in an appropriately collected
urine specimen. When it's appropriately collected, that means we haven't contaminated so we
got the sample from a person who doesn't have symptoms of a urinary tract infection. Okay,
in case that felt like I've talked to you in circles, let's take a look at it. This means I got a
sample from a client. I collected it appropriately. It was not contaminated. The patient isn't
showing symptoms of a UTI but when we did the culture, we identified that there is bacteria
in the urine. Before you look at the words on the slide, I want you to look at the pictures.
Clearly, that's a pregnant woman. Look on the other side and you've got a urinary catheter.
Now we can use catheters in multiple different situations. We can put an indwelling catheter
in and it stays in for a long period of time to drain urine. We can also use a procedure called
intermittent clean catheterization. Now you may not be aware of this but people at home it
isn't a sterile procedure. What we're thinking or the thought behind it is because they're in
their home setting, they don't have all the crazy bacteria that thrives in a hospital setting.
So they reuse their urinary catheters. That's why it's called a clean catheterization
procedure. So, when we're thinking about the 2 groups of people who are most likely to have
asymptomatic bacteriuria, meaning they've got bacteria in their urine but they're not showing
symptoms, the 1st category would be pregnant women, the 2nd one I want you to consider
are people with catheters, particularly people who use intermittent clean catheterization.
They are most likely to have bacteria present in their urine but not showing you signs of
painful urination or urgency or frequency, they just are positive for bacteria in their urine.
So the question becomes "Should we treat it or should we not treat it.?" Well, non-pregnant
patients like those who have spinal cord injury, they're doing frequent intermittent cath with
a clean catheter procedure, we don't need to treat those people. So, be clear if I have a
patient who is not a pregnant female, they may be someone who has a spinal cord injury or
someone who has a prolonged chronic indwelling catheter, we don't treat that asymptomatic
bacteriuria. Pregnant women are a different case. We do treat asymptomatic bacteriuria in
pregnant patients. So if it's a chronic thing, we don't treat it. We expect it. If it's due in
pregnancy, we absolutely treat that. Now the recommendation is for observation for 24 to
48 hours in afebrile patients who are clinically well without symptoms of UTI. So, you get the
culture back. You see that they have bacteria but they don't really have any symptoms. The
idea is we want you to watch them closely for 24 to 48 hours. See if they develop any further
symptoms of a UTI and also think are there some alternate causes for that positive bacteria
in their urine. So that's why you've got an eyeball and a spyglass looking at you because we
want you to observe them closely for 24 to 48 hours, and this can be done in the home
setting. Just tell the patient the types of symptoms you'd want them to report and you want
to do that for a minimum of 24 hours, so 1 to 2 days.